In a time of growing demand and diminishing resources, it is time to widen the lens in order to better understand and manage demand.
We know we must change, we can see it is possible, now to work out how.
We recently co-authored an article with Grant Thornton which explored the imperative to manage demand within children’s services through earlier intervention.
Our key reference point was the learning from a series of demand analysis projects that we have delivered with 12 different local authorities across the country. A key part of our analysis in these projects is to work alongside social workers and early help professionals, to conduct case reviews of children and young people who had become looked after. These reviews help us to understand the opportunities for earlier interventions that would prevent children becoming looked after, as well as the core issues that led to the breakdown of the family unit.
We sampled 10 to 25% of the LAC population in each authority, and asked social workers to review the selected cases. On average, 44% of the LAC cases were assessed as being possibly or definitely preventable. The scale of missed opportunity to make a difference by intervening and supporting earlier is indisputable.
The NCB report No Good Options highlights what we have seen from our projects across the country; the shrinking of early intervention resources, and a system characterised by late intervention. The stats speak for themselves; for every £1 spent on prevention, £4 is spent on child protection. The system is clearly unsustainable and has to change, and we welcome this being highlighted at a national level.
It is sad that it has taken financial pressures to unsettle the system and force local authorities (and government) to look at things in a new light. For me, there is also a danger in letting this discussion be financially led. Not only would that fail to engage the hearts and minds of people who can make a difference, but it may also undermine the approach we are looking to take.
I have seen councils lose faith in the early intervention and prevention agenda when unrealistic financial targets cannot be met, because they have been based on reducing demand too quickly and too soon. Notwithstanding the need for wisely allocated and well managed resources, if we focus on achievement of demand reduction outcomes in a safe and sustainable way, then the savings will follow.
Councils we have worked with have sometimes suggested that they simply adopt the learning on the level of avoidable demand from other authorities. Although the results across local authorities are largely consistent, we are keen that each of them goes through the process themselves. Undertaking the case reviews builds the vital buy-in and case for change, because it reflects the reality of children and young people’s lives, rather than the chasing of a financial target.
Importantly, the case reviews bring to light not just the role of early help and social care based in children’s services, but the impact of working in partnership, and the impact when those partnerships (despite best intentions) fall down. To echo No Good Options, supporting vulnerable children must be seen as ‘everyone’s business’. This is a systems issue, and the learning from the experiences of real children and families helps us to illustrate this.
Because the case reviews also give us much greater insight than high level data on primary need, they tell us more about the real issues that we need to be dealing with as a sector, and therefore what our response should be. We have for example, identified specific gaps regarding bereavement, domestic abuse and parental criminality. The reviews have also highlighted the critical gap in the skills and confidence of professionals to engage and build relationships with families. The learning from them also helps guide authorities to think not just about shifting to earlier intervention, but where to focus in terms of addressing the drivers of demand.
With the launch of a report such as No Good Options, which has clear resonance with the sector, there is a realisation that we simply cannot go on as we are. The next step of the journey is to move on from realising we need to shift the system, and to think about ‘how’. Our case reviews and demand analysis work are helping authorities to answer that question.